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Abstract: FR-PO320

Comparative Effectiveness of Cinacalcet Delivered Daily at Home vs. Three Times Weekly In-Center

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Karpinski, Steph, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Marlowe, Gilbert, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Colson, Carey, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Husarek, Kathryn, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Sibbel, Scott, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Ratkalkar, Vishal N., Georgia Renal and Hypertension Care, Newnan, Georgia, United States
  • Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
Background

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common syndrome found in end stage kidney disease (ESKD) patients and marked by dysregulation of three chemicals in the blood: calcium, phosphorus and parathyroid hormone (PTH). A recent review of the evidence showcases that treatment of CKD-MBD should be based on better control of all 3 elements. Cinacalcet, an oral calcimemetic (a PTH-lowering therapy), is one of many daily treatments that ESKD patients are often prescribed, contributing to a high total pill burden. Recent clinical trials have provided evidence that in-center administration of cinacalcet might be a safe and effective treatment option. In this study we sought to evaluate the comparative effectiveness of cinacalcet delivered daily at home versus three times weekly in-center.

Methods

This was a retrospective matched cohort study of 2,894 matched adult in-center hemodialysis patients at a dialysis provider between January 01, 2008 and September 30, 2022 who initiated their first ever calcimemetic therapy (non-exposed group: at home use or exposed group: in-center administration at the end of dialysis). Patients were matched (1:1) on: age at index date, body mass index, cinacalcet dose, and baseline phosphorous, calcium, and PTH. Patients were followed until censoring (i.e., lost to follow up) or 12 months after baseline, whichever occurred first. The primary outcome was achieving triple control of PTH, phosphorous and calcium.

Results

Fitted proportion model results show no statistical difference in achieving triple control between in-center or at home cinacalcet administration groups (Figure 1). In addition, there was no meaningful difference in control of any component.

Conclusion

In an observational, well-matched cohort administering cinacalcet in-center at the end of dialysis is non-inferior as prescribing cinacalcet for use at home.